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The evolution of health care systems in Nigeria: Which way forward in the twenty-first century
Ajovi Scott-Emuakpor
April-June 2010, 51(2):53-65
  93,756 2,865 -
Hepatitis B virus infection in Nigeria - A review
GO Emechebe, IJ Emodi, AN Ikefuna, GC Ilechukwu, WC Igwe, OS Ejiofor, CA Ilechukwu
January-March 2009, 50(1):18-22
Background:Hepatitis B virus infection is a pandemic and chronic infection may lead to chronic liver diseases which are often lethal. This review was done to assess the status of hepatitis B virus infection in Nigeria. Materials and Method:Source of information was mainly from published works in Nigeria and elsewhere. The information was extracted over period of 5 months from May to December 2007. Result: Since over 30years when pioneer works were done in Nigeria to the recent tunes the prevalence of hepatitis B virus infection has remained very high. In Nigeria, the transmission of hepatitis B virus occurs mainly during childhood and all the risk factors (like blood transfusion, sexual promiscuity, lower socioecomic status etc) implicated elsewhere in the spread of the virus in the general population also play role in Nigeria. Conclusion: Reduction in the of hepatitis B virus infection could be achieved by public enlightenment campaign, mass immunization of the children and adults at risk while antiviral drugs and immunostimulatory therapy should be provided for those already infected.
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Abstracts from Nigerian medical association annual scientific meeting. April 21- 25, 2010 International Conference Centre, Abuja

January-March 2010, 51(1):39-51
  13,973 550 -
Malaria treatment services in Nigeria: A review
Benjamin SC Uzochukwu, Ogochukwu P Ezeoke, Uloaku Emma-Ukaegbu, Obinna E Onwujekwe, Florence T Sibeudu
July-September 2010, 51(3):114-119
Malaria remains a major Public Health problem in Nigeria and causes death and illness in children and adults, especially pregnant women. Malaria case management remains a vital component of the malaria control strategies. This entails early diagnosis and prompt treatment with effective antimalarial medicines. The objectives of this review is to enable health professionals to understand the magnitude of malaria treatment services in Nigeria, to improve knowledge for rational malaria management within different health system contexts with a view to improving access to malaria treatment. The review therefore looks at the following areas: clinical disease and epidemiology; the burden of malaria in Nigeria; objectives of treatment; antimalarial treatment policy; malaria diagnosis, treatment strategies/ National responses; treatment sources. The review concludes that for improved malaria treatment services in Nigeria, there is an urgent need to develop adequate strategies that will ensure better access to medicines by getting evidence-based and effective medicines to the people who need them, whether by reducing their costs, promoting equity in access, improving their distribution, increasing their efficacy and acceptability, or slowing down the development of antimicrobial resistance.
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Community based healthcare financing: An untapped option to a more effective healthcare funding in Nigeria
Echendu D Adinma, Brian-D J. I. Adinma
July-September 2010, 51(3):95-100
Context:The Nigerian health system is characterized by chronic under funding. This has resulted in poor performance of the health sector evident from Nigerian's poor reproductive health indices. Objective: This review evaluates healthcare funding in Nigeria with respect to health budget and health expenditure, appraises the national health insurance scheme, and examines community health care financing as a plausible option to a more effective funding of healthcare in Nigeria. Pattern of health funding in Nigeria: Federal Government budget on health ranged from N 4, 835 million-N 17, 581. 9 million from 1996 to 2000. This amount represented only 2. 7%- 5. 0% of the total Federal Government budget. Nigerian's Total Health Expenditure (THE) as a percentage of Gross Domestic Product (GDP) is low ranging between 4. 3 %- 5. 5 % from 1996- 2005. General Government Health Expenditure (GGHE) as percentage of THE is also low ranging from 21. 8 %- 33. 5 %. Private sector expenditure on health as percentage of THE is high ranging between 66. 5 %- 78. 2 % from 19962005, with private households' out of pocket accounting for 90. 4 %- 95. 0 % over the period. Social security fund had no contribution to the general government expenditure over the 10-year period. The National Health Insurance Scheme (NHIS) currently covers only the formal sector of 4. 5 million people ( 3. 2 %) of the population. Community-based healthcare financing (CBHF): Community-based healthcare financing has been recognized as a community-friendly and community-driven initiative that has a wider reach and coverage of the informal sector especially if well designed. Experience with the Anambra State CBHF scheme, and a few other similar schemes in Nigeria indicate high acceptability of the people to CBHF scheme. Conclusion and Recommendations: Government and non-governmental organizations should collective develop various forms of CBHF to reach out widely to Nigerians.
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Trends in maternal mortality at University of Maiduguri teaching hospital, Maiduguri, Nigeria - A five year review
BM Audu, UI Takai, M Bukar
October-December 2010, 51(4):147-151
Background: Maternal mortality is on the rise in Nigeria with the North- East having the highest ratio, and Borno state records one of the highest maternal mortality ratios in the country. Objective: To determine the trends in maternal mortality in UMTH, identify the background socio- cultural factors, establish the major causes of deaths and determine avoidable factors. Study design: Retrospective study of maternal deaths. Methods: The case records of all recorded cases of maternal deaths between January 2001 and December 2005 inclusive were retrieved and relevant data obtained and analysed. Results: The maternal mortality ratio (MMR) for the period under review was 430 per 100,000 live births. There were annual fluctuations in MMR. However, there was a consistently rising trend in MMR from 2002-2004 with the highest ratio of 545 per 100,000 live births recorded in the year 2004, with a decline in 2005. Thirty (78.9%) of these deaths occurred among the unbooked patients and more than 90% of this were referred as obstetric emergencies. Age range was 14-39 years with a mean of 26.5years. The highest maternal death occurred at the two extremes of reproductive age group (14-19 years and 35 years and above). Grandmultiparas suffered the highest maternal mortality of 36.8%, followed by teenage mothers. P1-4 contributed the least to maternal mortality. The direct causes of maternal death accounted for 92.1% of the deaths. The major causes of death were eclampsia 34.2%, sepsis 26.3% and prolonged obstructed labour/ruptured uterus 13.2%. Amongst the indirect causes of maternal death, HIV/Tuberculosis was the leading cause accounting for 5.3%. Basic but professional antenatal care, skilled attendance at birth, community mobilization and health education messages for a healthy pregnancy and safe birth will help to reduce the unacceptably high maternal mortality ratio in Borno state and the country at large.
  7,793 713 -
Detection of extended spectrum beta-lactamases in gram negative bacilli from clinical specimens in a teaching hospital in South eastern Nigeria
CN Akujobi, Chika P Ewuru
October-December 2010, 51(4):141-146
Antimicrobial drug resistance seen among many gram-negative bacteria, especially those expressing the extended-spectrum β- lactamase (ESBL) enzymes that hydrolyze the expanded- spectrum cephalosporins has been on the increase. This has compromised treatment options and thus a threat to the containment of bacterial infections. To determine the existence of the extended-spectrum β-lactamase enzymes in Nnewi, 250 clinical isolates of members of the family Enterobacteriaceae and Pseudomonas species from Nnamdi Azikiwe University Teaching Hospital, Nnewi were identified by conventional methods. These include Klebsiella species (96), E. coli (90), Pseudomonas species (37), Enterobacter species (13), Proteus species (6), Citrobacter species (5) and Salmonella species (3). Antimicrobial drug susceptibility testing was carried out on all the isolates by the disc diffusion method. Extended Spectrum Beta- lactamases were detected by the double disc synergy test. High level of antimicrobial resistance was noted in test organisms against some of the antimicrobial drugs: Ampicillin + Cloxacillin (93.2%), Tetracycline (90.8%), Streptomycin (82.4%), and Nalidixic acid (62%), and low level of resistance was observed against Ofloxacin (26.4%), Cefotaxime (28.8%) and Nitrofurantoin (28.8%). One hundred and forty four isolates (57.6%) were suspected ESBL-producers judged by their resistance to any of the third generation cephalosporins used but 40 (16%) actually produced the extended spectrum beta- lactamase enzymes. This shows the existence of Extended Spectrum Beta- Lactamase producing gram negative organisms in Nnewi. Considering the treatment difficulties, as well as the high cost of treatment associated with these organisms, concerted efforts are needed to contain their spread.
  7,397 599 -
Community participation and childhood immunization coverage: A comparative study of rural and urban communities of Bayelsa State, south-south Nigeria
Kalamawei Itimi, Paul O Dienye, Best Ordinioha
January-March 2012, 53(1):21-25
DOI:10.4103/0300-1652.99826  PMID:23271840
Background: Immunization coverage rates in Nigeria have remained very poor, in spite of numerous programs and strategies, specifically designed to improve coverage. This study was to assess the possible effects of greater community participation on immunization coverage, by comparing the immunization coverage in a rural community with a functional community health committee, with an urban community, with no distinct community structure. Materials and Methods: The study was carried out in Ondewari, a rural, riverine community, in Bayelsa State; and Yenagoa, the capital of Bayelsa State, south-south Nigeria; using a cross-sectional, comparative study design. The data were collected using a structured interviewer-administered questionnaire, administered on female head of households in both communities, with under-five children; and used to collect information on the socio-demographic characteristics of the respondents, the immunization status of children in the household below the age of 2 years, and reasons for none and incomplete immunization. Results: A total of 288 respondents were studied in the rural community, while 270 respondents were studied in the urban center. The respondents in the urban center were significantly younger (P<0.01), better educated (P<0.001), and had fewer number of children (P<0.01). The immunization status of children in the rural community was significantly better than those in the urban community (P<0.000). Only 11.46% of the children in the rural community were not immunized, compared to 47.04% in the urban community. However, the dropout rate in the rural community was much higher; with a DPT dropout rate of 77.34%, compared to 12.39% in the urban community. Most of the reasons given in the urban community for the incomplete immunization were linked lack of motivation, and include relocation (11.34%) and the adverse rumor about childhood immunization (17.23%), while the reasons in the rural community were mostly health facility related, and included the absence of the vaccinator (20.46%) and nonavailability of vaccines (26.64%). Conclusion: The immunization coverage in the rural community was surprisingly better than that of the urban community, which can be attributed to better mobilization and participation in the delivery of immunization services.
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Knowledge of diabetes and its associated ocular manifestations by diabetic patients: A study at Korle-Bu Teaching Hospital, Ghana
Godwin O Ovenseri-Ogbomo, Samuel Abokyi, GA Koffuor, Eric Abokyi
July-August 2013, 54(4):217-223
DOI:10.4103/0300-1652.119602  PMID:24249945
Background: Diabetes mellitus is a significant cause of visual impairment, hence adequate knowledge on this condition and its ocular manifestations is of immense importance to diabetic patients. Aim: To assess the knowledge of diabetic patients on the disorder and its ocular manifestations, and their attitude towards ocular examinations. Materials and Methods: A cross-sectional survey involving the use of a structured interview was conducted among diabetic patients attending the Diabetic Clinic of the Korle-Bu Teaching Hospital. Using Fishers Exact Chi-square (χ2 ) and Odds Ratios (ORs), data obtained was analyzed. Results: Only 103 (26.4%) patients knew the type of diabetes mellitus they were suffering from. Knowledge on ocular effects of diabetes mellitus was low and only 15 (3.8%) knew that it could affect the ocular refraction with no patient mentioning that diabetes mellitus could cause cataract or diabetic retinopathy. Attitude to routine eye examination was poor. As much as 135 (34.6%) had never had an eye examination since being diagnosed of diabetes. Knowledge of the type of diabetes mellitus the individual had or any ocular complication of this disorder was significantly related (OR: 4.22; P < 0.001 and OR: 2.55; P < 0.001) respectively to their attitude to seeking eye care. Conclusion: Diabetic patients' knowledge on diabetes mellitus and its ocular manifestations, and the attitude of diabetic patients towards eye examination were poor. Intensive health education by diabetes care givers and leaders of the Ghana Diabetic Association for diabetic patient is therefore required to improve attitude towards eye care to prevent visual impairment.
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Hepatitis C virus infection in Nigerians
OS Ejiofor, GO Emechebe, WC Igwe, CO Ifeadike, CF Ubajaka
October-December 2010, 51(4):173-176
Background: Hepatitis C virus is a chronic lifelong infection in the majority of patients who are infected with the virus. Not much is known and written/published about this virus in Nigeria. Objective: To assess the status of hepatitis C virus infection in Nigeria. Materials and method:Sources of information were mainly from published works in and outside Nigeria. The information was extracted over a period of 12 months from January to December 2009. Results: So far the prevalence of hepatitis C. virus infection is increasing in Nigeria, ranging from 4.7-5% in Ilorin, to 5.3-6.6% in Enugu, to 11% in Ibadan and 20% in Benin. Children and adults are all at risk of being infected especially sickle cell disease patients. Others include those who are exposed to the common risk factors like Blood transfusion, haemodialyisis, recycling of syringes and needles, sexual promiscuity. Conclusion: Reduction in the Hepatitis C virus infection could be achieved by Health education campaign of the general public and by support from government and non-governmental organizations for the to provision of antiviral and immunostimulatory drugs free of charge for those already infected.
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The human health implications of crude oil spills in the Niger delta, Nigeria: An interpretation of published studies
Best Ordinioha, Seiyefa Brisibe
January-February 2013, 54(1):10-16
DOI:10.4103/0300-1652.108887  PMID:23661893
Background: The health hazards created by oil exploration and exploitation are covert and slow in action. They are not given the deserved attention in official documents in Nigeria, even as they can be major contributors to the disease burden in oil-bearing communities. This study is an interpretation of the data reported in several published studies on crude oil spills in the Niger delta region, Nigeria. Materials and Methods: A manual and Internet search was conducted to extract quantitative data on the quantity of crude oil spilled; the concentrations of the pollutants in surface water, ground water, ambient air and plant and animal tissue; and the direct impact on human health and household food security. Results: An average of 240,000 barrels of crude oil are spilled in the Niger delta every year, mainly due to unknown causes (31.85%), third party activity (20.74%), and mechanical failure (17.04%). The spills contaminated the surface water, ground water, ambient air, and crops with hydrocarbons, including known carcinogens like polycyclic aromatic hydrocarbon and benxo (a) pyrene, naturally occurring radioactive materials, and trace metals that were further bioaccumulated in some food crops. The oil spills could lead to a 60% reduction in household food security and were capable of reducing the ascorbic acid content of vegetables by as much as 36% and the crude protein content of cassava by 40%. These could result in a 24% increase in the prevalence of childhood malnutrition. Animal studies indicate that contact with Nigerian crude oil could be hemotoxic and hepatotoxic, and could cause infertility and cancer. Conclusions: The oil spills in the Niger delta region have acute and long-term effects on human health. Material relief and immediate and long-term medical care are recommended, irrespective of the cause of the spill, to ensure that the potential health effects of exposures to the spills are properly addressed.
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The accuracy of 2D ultrasound prenatal sex determination
Blessing Ose-Emenim Igbinedion, Theophilus Oriazo Akhigbe
April-June 2012, 53(2):71-75
Background: Pregnant women have been curious about the sex of their unborn child. The advent of ultrasound, its application into medicine, and the revolutionary changes in its resolution and function has led to the ability to assign a sex to these unborn children, thereby allaying the anxiety of these women but with consequent emergent ethical, moral, psycho-social, and medico-legal issues. The objectives were to determine the accuracy of sonographic prenatal sex determination, perform binary classification test, and the impact it has, including mis-diagnosis. Materials and Methods: A prospective prenatal sonographic sex determination study on 205 consecutive consenting pregnant women aged 20-40 years in a private hospital in Benin between August 2010 and October 2011. Questionnaires were administered to these women before and after the scan and the women were told the sex of the fetuses and their feelings on the determined sex recorded. The sex at birth was confirmed and compared to the scan determined gender by their case note and telephone. Relevant discussions during the scan and later on were recorded on the questionnaires. The statistical package used was SPSS version 17 and binary classification tests were performed. Results: The sensitivity (98.2%) and binary classification components values of prenatal sex determination were high with the sensitivity of detecting a female higher than that of males. Two males were misdiagnosed as females. Most of the women were happy even when the sex differed from that which they desired. Conclusion: Prenatal sonographic sex determination has a high sensitivity index. Consequently we advocate its use prior to more invasive sex tests.
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Ectopic pregnancy: A 5 year review of cases at Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi
GO Udigwe, OS Umeononihu, II Mbachu
October-December 2010, 51(4):160-163
Background: Ruptured ectopic pregnancy continues to be a common life threatening emergency in our environment as well as a public health problem. Objective:This is to study the incidence, clinical presentation, risk factors and the management of cases that presented in our centre over a five year period. Methods:This is a retrospective study of cases of ectopic gestations managed in the gynaecological unit of NAUTH Nnewi from January 1 st , 2002 to December 31 st , 2006. Information was obtained from the case notes, theatre and labour ward registers. Results: During the period, a total of 2,746 deliveries were recorded while 556 gynaecological patients were admitted. Thirty six patients had ectopic gestations accounting for 1.3% of all deliveries and 6.5% of all gynaecological admissions. The peak age group was 26-30 years (44.4%); 28(77.7%) were married and 20 (55.6%) attained secondary school as their highest level of education. All 36(100%) of the patients were symptomatic at presentation. Abdominal pain, amenorrhoea and syncopal attack were the most common symptoms at presentation. Also, multiple sexual partners 27(75%), previous abortions 25(69.4%) and previous sexually transmitted infections 10(27.8%) were the most common risk factors present in the patients. Abdominal paracentesis 32(88.9%), ultrasound 8(22.2%) and urine pregnancy tests 7(19.4%) were most commonly utilized for diagnosis. None of the cases was diagnosed before rupture. Open abdominal surgery was the treatment employed in all the patients. Conclusion:Ectopic pregnancy is still a major challenge in gynaecological practice in our centre. Most cases present late making tubal conservation treatment inapplicable. This has far reaching implications in a society where there is high premium on child bearing.
  6,022 748 -
Knowledge, attitude and practice of cervical cancer screening among market women in Zaria, Nigeria
Saad Aliyu Ahmed, Kabiru Sabitu, Suleiman Hadejia Idris, Rukaiya Ahmed
September-October 2013, 54(5):316-319
DOI:10.4103/0300-1652.122337  PMID:24403709
Background: Cervical cancer is the most common genital cancer and one of the leading causes of death among female population. Fortunately, this cancer is preventable by screening for premalignant lesions but this is rarely provided and hardly utilised. We assessed the knowledge, attitude and utilisation of cervical cancer screening among market women in Sabon Gari, Zaria. Materials and Methods: This was a cross-sectional study to evaluate the knowledge, attitude and practice of cervical cancer screening among market women. A total of 260 women were administered with questionnaires which were both self and interviewer administered. These were analysed using SPSS version 11. Results: Respondents exhibited a fair knowledge of cervical cancer and cervical cancer screening (43.5%); however, their knowledge of risk factors was poor. There was generally good attitude to cervical cancer screening (80.4%), but their level of practice was low (15.4%). Conclusions: There was a fair knowledge of cervical cancer and cervical cancer screening among Nigerian market women in this study, their practice of cervical cancer screening was poor.
  6,191 388 2
Implications of low oral health awareness in Nigeria
OO Sofola
July-September 2010, 51(3):131-133
I congratulate the Nigerian Medical Association on this Golden Jubilee celebration. It is my opinion that time is apt for us all to have to reappraisal of health care delivery in Nigeria and fashion a practical and achievable way forward for the betterment of the health of the poor Nigerian. I thank the association for inviting me to participate in this symposium on "50 years of oral health in Nigeria". It is my hope and prayer that deliberations at this meeting would signal the beginning of a well planned and structured oral health care delivery system for Nigeria. My brief is to discuss the implication of low oral health awareness in Nigeria.
  5,879 471 -
Universities and medical education in Nigeria
AO Malu
April-June 2010, 51(2):84-88
Formal attempts at Medical Education in Nigeria began in 1927 with the establishment of an institution in Lagos for training medical manpower to diploma level. They were trained to practice only in Nigeria. The program was not popular and was discontinued. Following the report of the Elliot Commissions on higher education in West Africa it was decided to establish the University of London College at Ibadan, with a Faculty of Medicine as one of the initial faculties. This was realized in 1948. The debate on what type of doctor to produce for Nigeria ended with the decision to produce high caliber doctors of the same standing as British trained doctors. In 1960 the Ashby Commission on Higher Education in Nigeria recommended the establishment of more training institutions, including those for medicine. This led to the establishment of the University of Lagos with the College of Medicine. The three initial regional governments all established their universities with medical faculties. Medical education has expanded rapidly with the expansion of universities, and we now have Federal and State governments as well as other organizations or private individuals owning universities with medical schools. Regulation of undergraduate medical education has continued to be under the dual oversight of the National Universities Commission and the Medical and Dental Council of Nigeria. The main problems of the medical schools have been the shortage of properly trained staff and poor facilities, curriculum stagnation and lack of modern teaching and assessment instruments. To tackle these problems training in educational methods should be mandatory for academic staff; there should be greater synergy between the NUC and MDCN, and curriculums should be reviewed to reflect modern trends.
  5,922 357 -
Hydrocelectomy: Experience with inguinal approach in the adult
CC Nweze
January-March 2009, 50(1):12-13
The usual approach for hydrocelectomy in the adult is the scrotal route. The most troublesome problem following this method is a very discomforting scrotal swelling which creates much difficulty for the patient and the managing surgeon. This problem can be avoided by performing hydrocelectomy with a procedure using the inguinal approach in the adult. Apart from almost eliminating this post-operative problem of scrotal discomfort from marked swelling this method enables inspection, discovering of testicular malignancy and more safely taking appropriate actions on it. It also enables easy inspection, discovery and performance of appropriate actions on any co-existing inguinal hernia.
  5,917 177 -
Maxillary ameloblastoma: An enigma for the surgeon
SO Ajike, OO Omisakin, E. T. O. Adebayo, ND Chom, M. A. O. Samaila
April-June 2009, 50(2):47-51
Background:Ameloblastoma is a benign but locally aggressive odontogenic tumour. Worldwide, maxillary ameloblastoma is rare but its late detection renders adequate treatment difficult. Majority occur in the mandible with about 5-20% occurring in the maxillary bone. Objective: The purpose of this study was to analyze 21 cases of maxillary ameloblastoma seen and managed at the Oral and Maxillofacial Unit of Ahmadu Bello University Teaching Hospital, Zaria, Nigeria and Alba Clinic and Medical Centre, Kaduna, Nigeria. Study Design:A retrospective study of cases of maxillary ameloblastoma from all cases of ameloblastoma seen from January 1993 to August 2008. Data with respect to patient's sex, age, tumour location, clinical presentation, radiologic features, biological and histopathologic type, surgical treatment and recurrences were analyzed. Results:Out of 350 cases of ameloblastoma seen within the period, 21(6%) Patients were with maxillary am eloblastoma. Of the 21 cases, there were 13 males and 8 females, a male female ratio of 1.6 to 1, with an age range of 17-55 years (mean = 38.14), peaking at the 4 th and 5 th decades of life (61.9%). Tumour duration was from 3 months to 14 years. There were 18 unilateral and 3 bilateral swellings. Clinically, maxillary ameloblastoma presented with grotesque swellings, with antral involvement in 19 cases, teeth mobility/exfoliation. Radiologically, there were 20 multilocular and 1 unilocular radiolucent lesions. The most common histopathologic type was follicular (11, 52.4%).there were 22 procedures done on 21 patients; 21 maxillectomies and 1 enucleation. Follow up period of 18 patients was between 3 months and 10 years from which 3(16.7%) recurrences were observed. Conclusion:Ameloblastum a is uncommon in the maxilla. While maxillary ameloblastoma is indistinguishable histologically from its mandibular counterpart, it is very lethal. An excellent result achieved in this study was due to the radical mode of treatment of the multilocular variety. Rehabilitation postoperatively remains a challenge. Periodic life-long follow-up is recommended.
  5,607 358 -
Focal reactive lesions of the Gingiva: An analysis of 314 cases at a tertiary health institution in Nigeria
OA Effiom, WL Adeyemo, OO Soyele
January-March 2011, 52(1):35-40
Background: The aim of this study was to review the clinicopathologic features of focal reactive gingival lesions at the Lagos University Teaching Hospital, Nigeria. Methods: A retrospective review of cases of different focal reactive gingival lesions from the records of the Departments of the Oral Biology/Oral Pathology and Oral and Maxillofacial Surgery of the Lagos University Teaching Hospital between 1970 and 2008 was carried out. Available clinical data regarding age, gender, location, estimated duration of the lesion and treatment modality were obtained and analyzed. Results: Prevalence rate of focal reactive gingival lesions was 5.6%. Pyogenic granuloma (PG) was the most common lesions constituting 57% of the cases. Seventeen (9.5%) of the 179 cases of PG were pregnancy induced pyogenic granuloma. The female-to-male ratio was 1.7:1. All the 4 lesions occurred more in female patients than males. The mean age of patients at presentation was 30 ± 16.5 years. The lesions were commonly seen in the second and third decade of life and least commonly seen above the age of 60 years. The lesions were equally distributed on the maxillary and mandibular gingivae, and were mostly located on the buccal gingival of the jaws. Most (51.6%) of the lesions occurred in incisors/canine region. Recurrence of the lesions was seen in 9 cases (2.9%), all pyogenic granuloma. Conclusion: Focal reactive gingival lesions are relatively uncommon lesions of the oral cavity with a prevalence rate of 5.6%. The lesions occurred commonly in females, and in third decades of life. Pyogenic granuloma was the most common lesions constituting 57% of all cases.
  5,470 401 -
Incidence and patterns of cardiovascular disease in north western Nigeria
Akindele O Mukadas, Uba Misbau
July-September 2009, 50(3):55-57
Background:Cardiovascular disease (CVD) has been major problem in the developed and developing countries and its burden in these countries is overwhelming. There is a dearth of literature and data on the prevalence and patterns of CVD in developing countries, especially Nigeria. Objectives: This study was carried out to determine the most common cardiovascular disorder, the mostly affected age and sex groups and annual increase/decrease between 2001 and 2005 in Northwestern Nigeria. Methods: Our study reviewed the pattern and incidence of CVD in North western Nigeria. Case notes of patients in Aminu Kano Teaching Hospital and Usman Dan Fodio University Teaching Hospital were reviewed between 2001 and 2005. These two teaching hospitals provide tertiary health care services to six out of seven states that form north western Nigeria with a population of 29,720,322 Nigerians. Results: A total number of 4103 case notes of CVDs were reviewed out of which 2159(52.69%) were males while 1944(47.40%) were females. A steady rise in the incidence of CVD between 2001-2005 was observed. Hypertension (39.1%) was the most prevalent CVDs while congenital heart disease (1.1 %) had the lowest. Conclusion: It was concluded that hypertension was the most prevalent CVD while congenital heart disease was the lowest. A steady increase in the incidence of CVD was observed during the period under review.
  5,450 403 -
Prevalence of intestinal parasites among pupils in rural North Eastern, Nigeria
JG Damen, J Luka, EI Biwan, M Lugos
January-March 2011, 52(1):4-6
Background : The study determined the prevalence of intestinal parasitism among pupils in rural schools (Almajiris) in Konduga local Government Area of Borno state. Materials and Methods: A total of 257 stool specimens were collected at random among pupils (Almajiris) in rural quranic schools; the stools were processed and examined both macroscopically and microscopically by concentration techniques. Results: The prevalence of intestinal parasitism among the Almajiris was 80.9%. The highest prevalence rate was 97.8% while the least prevalence was 67.4%. The 6-8 years age group had the highest prevalence of 85.7% while the least prevalence of 77.7% in the 13-16years age bracket. Ascaris lumbricoides had the highest prevalence of (19.1%) while Trichuris trichiura had the least prevalence of (3.5%). Thirteen pupils in the 5-8 years had multiple parasites; multiple parasitism also occurred in 22 pupils aged 9-12 years and in 11 pupils aged 13-16 years. Conclusion: There is a high prevalence rate of intestinal parasites with attendant risk of intestinal obstruction among the Almajiris in rural north eastern Nigeria.
  5,200 597 -
Effect of coconut oil in plaque related gingivitis - A preliminary report
Faizal C Peedikayil, Prathima Sreenivasan, Arun Narayanan
March-April 2015, 56(2):143-147
DOI:10.4103/0300-1652.153406  PMID:25838632
Background: Oil pulling or oil swishing therapy is a traditional procedure in which the practitioners rinse or swish oil in their mouth. It is supposed to cure oral and systemic diseases but the evidence is minimal. Oil pulling with sesame oil and sunflower oil was found to reduce plaque related gingivitis. Coconut oil is an easily available edible oil. It is unique because it contains predominantly medium chain fatty acids of which 45-50 percent is lauric acid. Lauric acid has proven anti inflammatory and antimicrobial effects. No studies have been done on the benefits of oil pulling using coconut oil to date. So a pilot study was planned to assess the effect of coconut oil pulling on plaque induced gingivitis. Materials and Methods: The aim of the study was to evaluate the effect of coconut oil pulling/oil swishing on plaque formation and plaque induced gingivitis. A prospective interventional study was carried out. 60 age matched adolescent boys and girls in the age-group of 16-18 years with plaque induced gingivitis were included in the study and oil pulling was included in their oral hygiene routine. The study period was 30 days. Plaque and gingival indices of the subjects were assessed at baseline days 1,7,15 and 30. The data was analyzed using paired t test. Results: A statistically significant decrease in the plaque and gingival indices was noticed from day 7 and the scores continued to decrease during the period of study. Conclusion: Oil pulling using coconut oil could be an effective adjuvant procedure in decreasing plaque formation and plaque induced gingivitis.
  5,307 252 2
Spontaneous rupture of gravid horn of bicornuate uterus at term - A case report
Betrand O Nwosu, Joseph O Ugboaja, Amaka Obi-Nwosu
October-December 2010, 51(4):184-185
Uterine structural abnormalities are known causes of recurrent pregnancy losses occurring especially within the second trimester. However, recent reports show that the rate of pregnancy losses caused by uterine anomalies may not be as high as previously feared. We report a case of a 28 year old secondigravida with uterus bicornis unicollis who had spontaneous rupture of one of the uteri in pregnancy, had excision of one horn of the double uterus and was able to carry a subsequent pregnancy to term and achieve a live birth. The literature on double uterus was also reviewed.
  5,156 249 -
Malaria in Pregnancy
EE Okpere, EJ Enabudoso, AP Osemwenkha
July-September 2010, 51(3):109-113
Malaria remains one of the highest contributors to the precarious maternal mortality figures in sub-Saharan Africa. At least 6 million women worldwide are at risk of malaria infection in pregnancy. Malaria contributes to at least 10, 000 maternal deaths and to at least 200, 000 newborn deaths annually. Malaria is a contributor or aetiologic factor in pregnancy complications including anaemia, spontaneous abortion, prematurity and stillbirths. Pregnancy results in increased incidence and severity of malaria. Cerebral malaria, acute renal failure and severe anaemia, rare complications in adults living in malaria endemic areas, may complicate malaria in pregnancy. Research implicate reduced maternal immunity from increased steroid levels in pregnancy, increased attractiveness of pregnant women to mosquito bites and increased adherence of parasitized erythrocytes to Chondroitin sulphate A expressed in the placentae. This is worse in the first and second pregnancies. With infection with the Human Immunodeficiency Virus [HIV], the effects of malaria in pregnancy are even worse. Over the decades, there have been concerted worldwide collaborative efforts, spearheaded by the World Health Organization [WHO] and including governments and allied agencies to tackle the scourge of malaria in pregnancy. The main thrusts of such efforts have been: to increase the use of insecticide treated mosquito bed nets [ITN]; intermittent preventive treatment of malaria [IPT]; and adequate case treatment of acute malaria attacks in pregnancy. While for IPT, Sulfadoxine-Pyrimethamine [SP] combination has been proven to be of benefit in preventing acute and latent malaria in pregnancy and its associated complications, the WHO has introduced the use of Artemisinin-Combination Therapy [ACT] for the first-line treatment of uncomplicated malaria in pregnancy, the need to confirm malaria before treatment and the enforcement of completion of therapy once started. The Roll Back Malaria [RBM] campaign was launched as a strategy to curtail the incidence and scourge of malaria especially in the vulnerable groups including pregnant women. The Millennium Development Goals [MDGs] offer a new hope if adequately pursued to achieving eradication of malaria and its complications in pregnancy. There is need to support research into effectiveness and utilization of established and newer control measures.
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Universal precautions: Awareness and practice of patent medicines vendors in Enugu Metropolis, south east Nigeria
Patricia Nonye Aniebue, Emmanuel Nwabueze Aguwa, Emmanuel Ikechukwu Obi
January-March 2010, 51(1):30-34
Aim:To determine patent medicine vendor's awareness and practice of universal precautions. Methodology: This study was a descriptive cross-sectional study carried out in Enugu metropolis, Enugu State, Nigeria in November, 2008. Three hundred and thirty seven patent medicine vendors were studied using semi-structured interviewer administered questionnaires. Information on awareness and practice of universal precautions were obtained. Results: Two hundred and four ( 60. 5%) of the patent medicine vendors had secondary education. Two hundred and sixty three ( 78%) were not aware of the concept of universal precautions. Of the 74 who had heard of the concept, the mass media was the source of information for 38 ( 51. 4%) of them. Most ( 67. 7%) of patent medicine vendors treat open wounds and administer injections. The proportion who take some precaution or the other ( 50. 7%), is similar to those who do not ( 49. 3%). One hundred and forty four ( 42. 7%) of them, dispose of used sharps inappropriately. Two hundred and twenty three ( 66. 2%) of them are aware of the need for appropriate action after a needle prick; i.e., through accessing HIV screening services or consulting a doctor. Conclusion and recommendation: The patent medicine vendor's awareness and practice of universal precautions is poor. Regular training on universal precautions is recommended.
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